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JULIAN C. LESLIE
University of Ulster at Jordanstown
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study where all participants watched the same video material of a teacher
using reinforcement techniques with children. If the video material was
labeled as "humanistic education" it was rated more favorably and as more
likely to promote academic learning and emotional growth, than if it was
labeled as "behavior modification" (Woolfolk, Woolfolk, & Wilson, 1977). A
similar phenomenon is evident in the results of a survey where several
student groups were asked whether behavior modification should be used
with various target groups (Boivin, Sewell, & Scott, 1986). The attitudes
expressed depended on whether the target group was one stigmatized by
the group from which the students were drawn.
To summarize, various long-standing factors combine to make it
likely that behavior modification will be inaccurately perceived as
coercive. However, this perception seems to be lessening, and this trend
may be continued by exercises such as the present one from within
behavioral analysis which seek to explicitly identify and comment upon
misconceptions, and it may be appropriate for behavior analysts to take
further steps in other media to correct these errors. I will now briefly
review the ethical foundations of behavior modification from the
perspective of behavioral analysis itself, and I will go on to consider
some contemporary issues.
The Ethics of Behavioral Analysis and Behavior Modification
It is not usual for psychologists to give prominence to ethical issues,
and Skinner is no exception. However, in writing about the application of
behavioral analysis to significant issues in human behavior, Skinner (1953,
1971, and elsewhere) stresses three issues which have general ethical
implications: the use of positive reinforcement, the minimization of
punishment contingencies, and the specification of objectives. The first two
of these taken together produce a policy of "accentuating the positive," of
focusing on the reinforcement of desirable behavior, rather than on the
elimination of undesirable behavior. In the broader sphere, the
recommendation of positive reinforcement with minimization of punishment
is an effective public relations strategy which counters the negative media
image discussed above. It is not, however, an "ethically neutral" approach.
Rather, it involves a set of judgments that have ethical components. These
are firstly the view that, other things being equal, positive reinforcement
contingencies are preferable to those that involve aversive events, in that
they are morally more acceptable. Secondly, there is the view that
pragmatically positive reinforcement contingencies are preferable because
they do not generate undesirable "side-effects" (such as fear, escape, and
avoidance). Thirdly, there is the judgment, based like the second one on
research findings, that positive reinforcement contingencies are at least as
effective as those involving aversive events. However, as we shall see later,
this final judgment is not the inevitable conclusion of an analysis of the
behavioral analysis literature.
Skinner's third precept, the importance of the specification of
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objectives, has proved the least controversial and perhaps the most
important in establishing behavior modification as a major strategy for
psychological and behavioral change. This precept also has ethical
implications. Making the specification of objectives a high priority helps
rebut the claim that behavior modification is manipulative. That is, in
behavioral analysis or behavior modification it is standard procedure for the
client and the psychologist or other professional to agree the objectives and
methods of treatment prior to the start of that treatment. Consequently, and
in contrast with some psychoanalytic traditions, the client of a behavioral
program is aware of, and in agreement with, the key elements of treatment
throughout the process.
Further ethical implications of the behavior-analysis approach emerge
if we consider a recent and useful summary by a behavior analyst which
addresses all the points originally made by Skinner. Owens (1995) states
that the general strategy when a client and therapist come together to
resolve a behavioral problem should be as follows: A functional analysis of
the client's problem should lead to shared decisions on objectives and
methods of treatment, but that all the treatments selected should involve
positive reinforcement. The additional explicit feature here is the reference
to functional analysis, which has become a very important part of the
contemporary behavior analysis strategy. Functional analysis has become
important because another feature of the Skinnerian inheritance is a
commitment to the use of effective contingencies, or the view that if a
contingency has powerful effects on behavior it should be regarded as
important (see Sidman, 1960, for a discussion of this and alternative
theoretical perspectives). In considering the problems of a particular client,
we need to know which contingencies currently maintain his or her behavior
or could change it if they were introduced. Identifying currently effective
contingencies is the objective of a functional analysis of their behavior,
which should occur through a behavioral assessment and form the basis of
the intervention strategy. Obviously, it is important that the "correct"
contingencies be identified, and much effort has been directed in recent
years to the development of techniques of functional analysis. Currently
there is a consensus about the importance of functional analysis, but none
as to how it should be carried out. The lack of consensus raises an ethical
issue, because if a treatment is selected based on an inaccurate functional
analysis it is likely to be unsuccessful, and the behavioral analysis
practitioner will, by his or her own standards, have behaved in a
professionally incompetent fashion.
In Owens's scheme, the second step towards resolution of a behavioral
problem is a shared decision between the behavioral analysis practitioner
and the client about the objectives and methods of treatment. This is
certainly a crucial event, from an ethical point of view, because, as outlined
earlier, it reduces the risk that the clients' are coerced by having the
practitioner impose treatments or objectives unbeknown to them. However,
ethical issues remain. Owens states: "the individual ... and the
professional ... form an equal partnership where it is recognized that both
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are attempting to solve a common problem and both have clearly defined
areas of expertise. The professional has the technical expertise, knowing
how likely it is that certain options are feasible; the person with the problem
has personal expertise, knowing more about their own life than anyone else
and which of the available options are preferable to others." (p. 14). Given
the power differential between professionals and clients, a truly equal
partnership is a rather unlikely scenario, and a great deal more social
power rests with even the best-intentioned professional than with the client.
Consequently, the professional should engage in various routine
procedures to ensure that treatment decisions are made on the equal basis
which Owens recommends. These procedures should, where possible,
involve sharing information with colleagues about the decisions made and
the basis for them. Whether or not it is possible to involve colleagues
directly, the information should be made public in the form of a contract
between the professional and the client which states the methods and
objectives, and the reasons for these choices.
Let us now examine the view, shared by Skinner and Owens, that
punishment should not be used, and thus positive reinforcement should be
used more or less exclusively. In general, situations involving aversive
events set up a variety of contingencies that can produce unwanted and
sometimes unexpected outcomes. A punitive regime in school, for example,
may produce compliant, or at least docile, behavior during class, at the
possible costs of frequent school refusal, parent dissatisfaction, and
students who do not wish to continue in education and who have negative
attitudes to school when they themselves become parents. Nonetheless, a
functional analysis may reveal how we can influence the behavior that is of
central concern, and it may suggest interventions that do involve aversive
events. For example, difficult issues often arise in the treatment of selfinjurious behavior, which can prove insensitive to the introduction of positive
reinforcement contingencies designed to increase the frequency of
alternative behavior. If, in such a case, functional analysis has suggested
that a punishment contingency might prove effective, its use should surely
be considered (see Rolider, Cummings, & Van Houten, 1991, for an
example of this).
To summarize the foregoing discussion, behavior analysts concur with
others, including many moral philosophers, in recommending that positive
reinforcement be preferred to punishment contingencies. Further, they
recommend that the objectives of any intervention in a client's life to change
their behavior should be made explicit, they should be based on a full
consideration of the methods of intervention and their possible
consequences, and the results of that consideration should be available to
the client. However, behavior analysts do not hold the view that punishment
(or other procedures involving aversive events) are a/ways wrong. Rather
they believe that these procedures are most often wrong because their
overall effect will be to reduce the quality of life for the client (or, more
broadly, for all those influenced by the treatment program). The best
decisions about treatment or intervention will be based on case-specific
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here to the LRA principle. They derive from the average views of a wider
community, in this case one of practicing psychologists, and specific
ethical principles may not be supported by functional analysis. They are
sets of higher order principles, and again it could be said that until
behavior analysis achieves a higher standard of competence in
functional analysis it is wise to operate strictly within a professional code
of ethics. Once it becomes clear that a particular code conflicts with the
regularly obtained results of functional analysis in certain cases, it
should be possible for the profession to modify the corresponding
aspects of the code. Hypothetically, it might be established that there is a
type of agoraphobia where functional analysis regularly indicates that
successful intervention involves making the client's home environment
less attractive (and thus making the outside world more attractive), but
current ethical codes are likely to proscribe such intervention. This
process of accruing evidence and then relating it to the existing code
amounts to the empirical assessment of higher order principles.
Applications to Contemporary Issues
The latter part of this discussion brings us close to two issues which
have become more important in the last two decades of practice in
behavior modification, and which each have ethical implications that are
worth exploring. These are social validity and parent training.
Wolf (1978) defined social validity of behavioral analysis as assessing
public opinion on the social significance of its goals, the appropriateness of
its procedures and the importance of its effects. Since then, social validity
assessments have been included in around one-fifth of the reports
published in two of the main journals (Kennedy, 1992). Use of social validity
techniques raises a variety of ethical issues which must be balanced in the
final design of programs. For example, these techniques regularly show
that the use of physical punishment is markedly less acceptable to the
general public than other possible aversive interventions (see for example,
Blampied & Kahan, 1992). We have seen that a general ban on certain
procedures may be in conflict with the results of functional analysis, but, on
balance, social validity exercises help to ensure that behavior analysts
behave in a more ethical fashion. That is, social validity is enhanced if
participants other than clients and the wider community are fully informed
about the choice of methods and goals of a program, are able to debate
these with the designers of the program, and thus be actively involved in
the design. This involvement is clearly consistent with the general objective
stated earlier of making public the aims and objectives of any program, and
may indeed go further by involving a wider range of people in selecting
those aims and objectives.
Parent training, and involvement of parents, other carers, and family
members in the implementation of behavior-modification programs,
similarly carries possible ethical costs and benefits. The possible costs are
serious because there are real risks that the procedures will not be
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References
AMERICAN PSYCHOLOGICAL ASSOCIATION. (1992). Ethical prinCiples of
psychologists and code of cond uct. American Psychologist, 47, 1597-1611.
BERNSTEIN , G. S. (1992). Training behavior change agents. Behavior
Therapy, 13, 1-23.
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